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Journal of Pain & Palliative Care Pharmacotherapy

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https://www.readbyqxmd.com/read/30624123/things-to-consider-when-completing-an-advance-directive
#1
Leanne C Laramie, Kathryn M Smolinski
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. In response to a question about advance directives for a patient experiencing chronic pain, the authors discuss the importance of having legal documents in place.
January 9, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30596459/a-cost-and-quality-analysis-of-utilizing-a-rectal-catheter-for-medication-administration-in-end-of-life-symptom-management
#2
Natalie M Latuga, Mary Gordon, Paula Farwell, Megan O Farrell
Technology that can improve the ability to provide quick symptom control while decreasing the cost and burden of care could help hospice agencies deal with current hospice industry challenges. This paper describes how the use of a new rectal medication delivery technology at a large hospice in western New York has improved patient care and nursing efficiency while at the same time decreasing the cost of care.
December 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30592628/a-case-of-opioid-induced-hyperalgesia
#3
Jillian Wall, Alpna Chauhan
We report the case of a 76 year old lady with metastatic breast cancer, who presented to a hospice in severe distress from uncontrolled pain despite an increase in her opioid dose, alongside generalised hypersensitivity and delirium. The clinical presentation suggested opioid-induced hyperalgesia (OIH). After reduction of the opioid dose, our patient significantly improved to the extent she was discharged home a few weeks later. This report aims to increase awareness of OIH, a clinical phenomenon which remains poorly understood and probably under recognised...
December 28, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30589375/a-preliminary-study-of-pain-relieving-dressings-for-older-adults-with-chronic-leg-ulcers-from-the-provider-s-perspective-a-qualitative-study
#4
Rachael Docking, Joshua Boateng, Ovidio Catanzano, Patricia Schofield
Prevalence of leg ulcers increases with age due to an increase in risk factors, including immobility and venous disease. With an increasingly aging population, therefore, the number of older adults with leg ulcers is increasing. Older adults with leg ulcers experience frequent pain and discomfort, and yet pain in this population is poorly managed. The aim of this study was to explore the feasibility of the use of analgesic dressings in older adults with leg ulcers, including their perception of current pain management, feasibility of an analgesic dressing, and potential challenges...
December 27, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30589369/retrograde-intrathecal-drug-delivery-a-report-of-three-cases-for-the-management-of-cancer-related-sacropelvic-pain
#5
Uri Hochberg, Jordi Perez
We report three cases of sacral and pelvic pain resistant to oral medications successfully managed with intraspinal drug delivery through a catheter placed at the intrathecal sacral space to deliver low doses of bupivacaine and fentanyl with local effects.
December 27, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30395777/a-treatment-for-refractory-high-ileostomy-output
#6
Shana Semmens, Elizabeth Higgins, Patrick Coyne
We present a case where the glucagon-like peptide 2 (GLP-2) analog teduglutide was used successfully to decrease high ostomy output due to short bowel syndrome in a patient not entirely dependent on parenteral nutrition. Short bowel syndrome is known to decrease quality of life and is associated with high health care costs. Although use has been limited by cost, teduglutide appears to be a treatment option for palliative care practice if patients suffer from short bowel syndrome.
November 5, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30380977/intravenous-chlorpromazine-for-the-short-term-treatment-of-insomnia-in-end-stage-cancer-patients-with-difficulty-in-oral-administration
#7
Hideaki Hasuo, Ryohei Fujii, Kazuki Uchitani, Hiroko Sakuma, Kenji Kanbara, Mikihiko Fukunaga
The objective of the study was to evaluate effectiveness and safety of intravenous chlorpromazine for the short-term treatment of insomnia in end-stage cancer patients. Insomnia occurs as one of distressing symptoms in 70% of end-stage cancer patients. End-stage cancer patients often have difficulty in oral administration because of disease progress. We retrospectively evaluated 30 end-stage cancer patients with difficulty in oral administration who received intravenous chlorpromazine for the short-term treatment of insomnia...
October 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30380966/comment-on-gressler-et-al-serotonin-syndrome-in-tapentadol-literature-systematic-review-of-original-research
#8
Tatjana Radic, Ariane Stollenwerk, Christian Elling
No abstract text is available yet for this article.
October 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30198819/prescription-drug-monitoring-programs-relationships-among-program-awareness-use-and-state-mandates
#9
Kristi Skeel Williams, Selena Magalotti, Karyssa Schrouder, Michele Knox, Lance Feldman, Deepa Ujwal, Denis Lynch
The inappropriate use of opioids in the United States has increased markedly and has resulted in a tragic loss of lives. To combat this problem, prescription drug monitoring programs (PDMPs) have been instituted in most states. Use of the programs is voluntary for prescribers in some states, whereas in other states it is mandatory. The current study used a self-report survey instrument that was administered to 223 participant physicians. The goal of the study was to compare awareness and use of the PDMP in a state that mandates use (Ohio) with one that does not (North Carolina)...
September 10, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30198811/ensuring-and-restoring-balance-on-access-to-controlled-substances-for-medical-and-scientific-purposes-joint-statement-from-palliative-care-organizations
#10
Katherine Pettus, Liliana De Lima, Martha Maurer, Asra Husain, Stephen Connor, Julie Torode, Julie Ling, Julia Downing, M R Rajagopal, Lukas Radbruch, Tania Pastrana, Emmanuel B Luyirika, Cynthia Goh, Joan Marston, James Cleary
The central principle of "balance" represents the dual obligation of governments to establish a system of control that ensures the adequate availability of controlled substances for medical and scientific purposes while simultaneously preventing their nonmedical use, diversion, and trafficking, two primary goals of the international control system. On the one hand, although strong opioids, including morphine, are absolutely necessary for the relief of severe pain, legitimate access to opioids for pain treatment and palliative care is lacking in the majority of the world's countries...
September 10, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30383501/pain-scale
#11
Corbin Bugni
No abstract text is available yet for this article.
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30212267/interstitial-cystitis-an-update-on-the-disease-process-and-treatment
#12
Amanda M Daniels, Adam R Schulte, Christopher M Herndon
Interstitial cystitis (IC) is a chronic pain disorder of the bladder that is often underdiagnosed and mistreated. The difficulties in diagnosis stem from numerous theories regarding pathophysiology and etiology, including the breakdown of the glycosaminoglycan (GAG) layer, altered permeability of the urothelium, uroinflammation, and neural up-regulation. Dysfunction of the bladder increases the struggle for proper treatment and continues to prove difficult for health care providers to correctly diagnose and manage IC...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30204513/identifying-patterns-of-delirium-in-hospitalized-patients-on-dexamethasone-using-a-chart-abstraction-tool
#13
Jane T Chang, Rabia S Atayee, Kyle P Edmonds
Delirium is a neuropsychiatric syndrome that can occur in hospitalized patients, including in palliative care settings. The aim of this study is to describe patterns of delirium in patients receiving dexamethasone at the request of an inpatient palliative consultation team by using a modified chart abstraction tool. This retrospective study analyzed patterns of delirium development in adult hospitalized patients receiving opioids for cancer-related pain and initiated on dexamethasone with recommendation from the palliative care team...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/30204508/opioid-and-benzodiazepine-relative-use-in-breast-cancer-patients-before-during-and-after-curative-chemotherapy
#14
Warren H Yau, Eric J Roeland, Carolyn Revta, Amine Ale-Ali, Joseph D Ma
No abstract text is available yet for this article.
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29799322/a-new-editor-in-chief
#15
Kenny Jackson
No abstract text is available yet for this article.
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29791238/low-dose-ketamine-infusion-for-adjunct-management-during-vaso-occlusive-episodes-in-adults-with-sickle-cell-disease-a-case-series
#16
Nicole Palm, Catherine Floroff, Tanna B Hassig, Alice Boylan, Julie Kanter
The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs)...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29787324/provider-perspectives-on-topical-analgesics
#17
Michael A Smith, Katherine Cho, Phillip Rodgers
Topical analgesics are effective and alternative means to systemic therapy, often minimizing the adverse drug effects and complications of systemic analgesic use. Despite the number of available topical analgesics, there is little direction provided in practice guidelines on their appropriate use and little is known about patterns of their prescribing. To begin understanding these knowledge gaps, we sought provider perspectives on topical analgesic use at a large academic medical center. This electronic survey seeks to explore the perceptions and prescription patterns of topical analgesics among prescribers in a large academic medical center, where the availability of topical analgesics varies...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29775120/successful-improvement-of-pain-symptomatology-in-a-suspected-case-of-cramp-fasciculation-syndrome-via-interventional-pain-treatment
#18
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29764265/use-of-methadone-to-reverse-opioid-escalation-in-a-patient-with-surgical-pain
#19
Muhammad Jaffar, Gwin Cunningham, Michael Chandler, Thomas Webb
Acute pain is a prevalent issue for patients recovering from surgical procedures. Methadone has been recognized as a unique option for treatment of surgical pain due to its multiple mechanisms of analgesia and its potential to decrease tolerance to other opioids. Studies of methadone use in postoperative settings are sparse in part due to safety concerns, such as complex pharmacokinetics, risk of respiratory depression, and association with arrhythmias. In this case study of a 70-year-old male with postsurgical abdominal pain, methadone utilization over a period of 9 days resulted in patient-reported analgesia and aided in de-escalating overall opioid use...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29737933/case-report-utility-of-ketamine-lidocaine-and-mexiletine-as-nonopioid-adjuvants-in-complex-cancer-associated-pain
#20
Robert C Hakim, Kyle P Edmonds, Rabia S Atayee
Ketamine, lidocaine, and mexiletine are potential nonopioid adjuvant medications for the use of refractory cancer-related pain, particularly when opioids are demonstrating limited objective benefit. This is a case report of a single patient admitted to a large academic medical center in the United States. The patient is a 43-year-old woman with a history of Crohn's disease complicated by rectal squamous cell carcinoma and complex, progressive, and intractable pelvic and rectal pain. Over the course of hospitalization, her pain demonstrated limited opioid responsiveness despite marked fluctuations of her oral morphine equivalent doses...
March 2018: Journal of Pain & Palliative Care Pharmacotherapy
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